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Primary hyperfibrinolysis: Facts and fancies

Massimo Franchini1, Pier Mannuccio Mannucci2

  • 1Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantova, Italy; Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, University of Milan, Italy.

Thrombosis Research
|April 18, 2018
PubMed

Fibrinolysis is a complex process that controls both hemostasis and thrombosis. The regulation of the fibrinolytic system is mediated through a wide array of cofactors and inhibitors that maintain the hemostatic balance in a delicate equilibrium. As a consequence, disturbances in the fibrinolysis pathway are associated with various disease states, ranging from thrombotic to hemorrhagic clinical phenotypes. In particular, a number of inherited and acquired disorders are associated with an enhanced fibrinolysis leading to a bleeding tendency that in some cases may be life-threatening. Hyperfibrinolysis has been classified into primary and secondary forms but such differentiation, which may have important treatment implications, is still controversial. This narrative review will be focused on inherited and acquired conditions associated with primary hyperfibrinolysis.

Keywords:
AcquiredAntifibrinolyticsBleedingInheritedPrimary hyperfibrinolysis

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